DATE: ______________
Auto Debit Instruc on for HDFC Bank Credit card
CREDIT CARD NUMBER :
NAME OF CARD MEMBER :
SAVINGS / CURRENT ACCOUNT NO. :
APPLICATION REF. NO. :
BRANCH AND CITY. : ______________________________________________
Strikeout op ons which are not relevant
AUTO DEBIT ACTIVATION :
OR (Please ck the appropriate box)
AUTO DEBIT CANCELLATION :
I have applied for HDFC Bank credit card / I am a holder of HDFC Bank Credit Card ( no. men oned above)
I uncondi onally and irrevocably authorise HDFC Bank Ltd.,to debit my savings / current account ( no. men oned
above) / to cancel auto debit facility opted for
Minimum Amount Due [ MAD ] : 5% of total outstanding including EMIs, or Rs. 200/- whichever is higher
OR
Total Amount Due [ TAD ] : as indicated in the creditcard monthly statement.
I declare that the informa on given in this form is correct and complete. If this request is delayed or denied because of incorrect or incomplete
informa on in this form or for any other reasons, I will not hold HDFC Bank Ltd., responsible.
I agree that nominated HDFC Bank account will be debited for auto-pay on payment due date (PDD) as indicated in the credit card monthly
statement. If my account does not have sufficient funds, I will be liable to pay applicable charges as men oned in the Credit card terms and
condi ons.
I further agree that the auto debit instruc on cannot be withdrawn / cancelled without the wri en consent to HDFC Bank Ltd., by the account
holder. On account of cancella on of autodebit facility, I agree to pay my subsequent bills via other payment modes.
Account Holder's Name ________________________________ Signature ________________________________
Incase of Auto Debit mandate from a joint account, all account holders are requested to sign below
1. Primary Account Holder's Name ________________________________ Signature ________________________________
2. Second Account Holder's Name ________________________________ Signature ________________________________
3. Third Account Holder's Name ________________________________ Signature ________________________________
Note :
1. Only Savings / Current account holders of HDFC BANK Ltd. With opera ng instruc on of single / either orsurvivor / anyone or survivor, can
request for Auto debit.
2. In the absence of specific instruc on to carry out Autopay for either MAD or TAD, HDFC Bank will ac vate minimumamount due[ MAD ] op on
by default.
3. If sufficient balance is not available to claim total amount due (TAD) as opted, the cardholder authorises HDFC Bank to recover the MAD
amount to ensure that the cardholder's card account remains in good standing and does not lead to default in payment of atleast the MAD.
The cardholder however acknowledges and agrees that this shall be treated as failure by cardholder in adherence to their own AutoPay
instruc on for debi ng the TAD and therefore, the cardholder authorises the Bank to levy Autopay return charges on the net payable amount.
4. The cardholder further acknowledges and agrees that if par al payment is received prior to Payment Due date and subsequently the autopay
instruc on for payment of MAD and/or TAD, as opted by cardholder is returned unpaid, Autopay return charges shall be levied on the net
payable amount.
5. Autopay will be ac vated within 7 days from the date of incorpora on. If the payment due date is within these 7 days, please pay this cycle
payment via other payment modes (Netbanking / ATM Transfer / Cheque)
6. Autopay return charges will be 2% on the payment amount subject to a minimum of Rs. 450/-*(*Please note charges are subject to change at
the discre on of HDFC Bank. Any changes will be communicated to card holder)
7. Completed form shall be sent to - The Manager, HDFC Bank Credit cards division. PO Box 8654, Thiruvanmiyur P.O, Chennai 600041
8. Incase of cancella on of auto debit facility, customers shall pay subsequent months payment on or before payment due date [PDD]via other
available modes.
9. Most Important terms & condi ons document along with Card member agreement related T&C to be referred for addi onal clarity
